Role of polyetheretherketone (PEEK) in arthroplasty and orthopaedics: a review of biomechanical properties, surface modifications, and clinical outcomes

BACKGROUND: Polyetheretherketone (PEEK) has gained attention as an alternative to metallic implants in orthopaedic applications, including arthroplasty, due to its mechanical properties and biocompatibility. This review evaluates the role of PEEK in arthroplasty and other orthopaedic applications by analysing its biomechanical characteristics, surface modifications, and clinical outcomes METHODS: A comprehensive literature review was conducted using PubMed, PubMed Central (PMC), Scopus, and Embase. Eligible studies included randomised controlled trials, cohort studies, preclinical research, and systematic reviews. RESULTS: PEEK's elastic modulus (3-4 GPa) closely matches that of human cortical bone, potentially reducing stress shielding and enhancing osseointegration. Its inherent radiolucency improves imaging capabilities, while various surface modification techniques, including hydroxyapatite coatings and nanopatterning, have been developed to enhance bone integration. Despite positive preclinical outcomes, clinical studies are predominantly focused on short- to mid-term results, with limited long-term data on implant survivorship and complications. CONCLUSIONS: While PEEK shows promise in orthopaedic applications, further research is necessary to establish its clinical efficacy relative to traditional metals. Addressing the current gaps in long-term studies, regulatory challenges, and manufacturing processes will be crucial for the broader adoption of PEEK implants in orthopaedic surgery. This review highlights the ongoing evolution of PEEK in the field and suggests directions for future research.